New Student Registration Form

REGISTRATION FORM

Full Name (same as Passport/ID)

Nationality (same as Passport/ID)

M / F

Age

Email Address

WhatsApp Number

Which dates are you registering for?

Which Course/Retreat are you registering for?

What is your level of skill and experience in Taichi & Qigong? Beginner, Intermediate, Advanced?

What other energy training, healing skills or experience do you have?

Do you have any health issues?

What is your current state of health? Poor, Average, Good?

Do you have any questions?

Anything else you would like to share?

I agree to all Terms & Conditions on this webpage: https://taichibali.com/terms-conditions/ YES/NO

Your electronic signature (Full name same as passport/ID)

Today’s Date

If you are human, leave this field blank.